twin delivery...vaginal or c-section???

Specialties Ob/Gyn

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I work in a small hospital where we have 300-350 deliveries a year. We seem to have quite a few twin deliveries (2-4 a month). I'm curious what type of delivery your docs choose with twins. We have some that do vag only if both babies are vertex and some will do vag if presenting baby is vertex. Just wanting to know what other hospitals do, and if you have very many c/s after first baby delivered lady partslly.

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Specializes in Community, OB, Nursery.

I have seen one twin be vag & the other c/s but usually they will at least try to flip the 2nd twin if s/he's not vertex. (I have even seen them deliver 2nd twin breech though!! Yay!)

Most, however, are both vag or both c/s. If they're both breech, it's pretty much an automatic c/s. I have seen in the last few months an increase in the # of vag twins, which makes me very happy. HTH.

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My sil had 2 sets of twins (no fertility drugs!)

First set, and her first pregnancy, they were born lady partsl. They were in excellent position.

Second set, she didn't get as big and both babies were breech. Scheduled c/section.

I did OB one day where we had a pregnant mom due with twins (sorry, I don't know all your lingo, previa, etc.) One baby was breech and the other vertex. First baby deliverd lady partslly and the doc hoped that the other baby would flip once it had more room. Ended up getting a shoulder stuck (again, sorry for lack of med language) and was emergency c-section. Scary situation. Just think, poor mom had to deal with episiotimies and a c-section. Got both ends.

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Specializes in L&D.

My twins were vertex/footling breech, both born lady partslly one minute apart. B was a breech extraction. My OB was very experienced, and does more multiples than any other docs in her practice - she only sections if A is breech or transverse, otherwise there will at least be a TOL.

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Specializes in Community, OB, Nursery.
My twins were vertex/footling breech, both born lady partslly one minute apart. B was a breech extraction. My OB was very experienced, and does more multiples than any other docs in her practice - she only sections if A is breech or transverse, otherwise there will at least be a TOL.

Good for you, and good for your doc. :balloons:

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Specializes in Maternal - Child Health.

In my experience, it depends on the age of the doctor. Most older (over 50) OBs seem willing to attempt lady partsl deliveries of twins at least in part because they are more skilled than the younger docs in breech deliveries. I don't recall any situations in which mother delivered one lady partslly and then required a C-section for the second.

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Specializes in NICU, High-Risk L&D, IBCLC.

We had a lady partsl twin delivery within the past few months where twin A was vertex and twin B was breech. Unfortunately, this is more the exception rather than the rule because most of our docs will go straight for the section.

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Specializes in Med/Surg.

My experience (13 yrs ago): My doctor(s) were unwilling to try a lady partsl birth if the presenting twin was breech. Had baby A not been breech (he looked like he was sitting on my cervix), we would have tried. (even though I was really apprehensive about the possibility of having one baby lady partslly and then needing a CS for baby B).

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We have a couple of docs that will attempt vag twins if both are vertex. Most get sectioned, though.

Mine were vertex and I delivered lady partslly. 6 & 7 Lb. boys... Husband caught twin A as he precip'd and then the midwife made it for B. My 9 Lb. daughter had paved the way. LOL

My cousin's wife many years ago (20+) had triplets lady partslly and one was breech. They ranged from 4-5 pounds. She had delivered one child lady partslly before them. They all did very well and are all normal, healthy boys (men).

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Specializes in RN- Med/surg.

I delivered twins in a small hospital. One was breach, so my dr scheduled a C-section. I could have transfered to a larger facility where they would have opted to deliver vag....but I prefered a dr I was comfortable with. Also...I didn't want to end up having one vag and one C-section.

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Specializes in postpartum, nursery, high risk L&D.

Most of our docs will try for a vag delivery if baby A is vertex even if B isn't, and will attempt to flip baby B after A is delivered. But only a couple will deliver baby B breech, the rest will section the pt.

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Specializes in L&D.

If the first baby is vertex, most of the docs I work with will go for lady partsl. We do all breech deliveries in the OR just in case the second twin has to be sectioned. The second twin tends to have a tougher time than the first one: prolapse a cord, settle into a bad position after A is delivered, placenta abruption, stuff like that. We don't do our own sections and the OR hates to have to stand around and wait and tie up one of their rooms. Oh well!! Last week, we delivered twins 2 hours apart: A lady partsl, B Section because he just wouldn't come down. AT least the OR didn't have to stand around waiting for nothing. They just hate it when we have a "failed section" over there and a patient delivers lady partslly.

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